9. QFT’s
Kidney quality form transplantation
11- 11- 13 13:20
Kidney quality form transplantation
11- 11- 13 13:20
Aspect perfusion Good
Biopsy
Logged in: A.E. Braat, 11-11-2013
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Parenchyma abnormal
Tear(s) in capsule
Subcapsular hematoma
Kidney quality form transplantation
Parenchymal rupture
Cyst(s)
Tumor(s)
Organ detail
ET Donornumber 150334
Perirenal fat
Organ Right Kidney
Donor type Heart Beating
Organ status Accepted
Perirenal fat
Transplantation center Leids Universitair Medisch Centrum
* Transplantation surgeon
Registered Quality Form Donation
discrepancies.
Agree
Disagree
Registration date QFT 11-11-2013 13:18
A.E. Braat
Perirenal fat removed
Transplant data
Please select Agree or Disagree. If 'Disagree', please specify
Transplant data
Agree
Disagree
Final evaluation
Agree
Disagree
Packaging
Packaging
Agree
Disagree
Morphological variations
Packaging adequate Yes Number of bags below 3 No
Leakage No
Low amount of fluid No
Additional comments
Organ frozen No
Blood samples included Yes
Spleen sample included Yes
Final evaluation
General information
End nephrectomy
Preservation method
Quality of kidney Good
Arterial anatomy/status
Organ injured No
Arterial anatomy/status
Agree
Disagree
Final result
Organ transplanted
Number of arteries 1
Aortic patch Yes
Arteriosclerosis Moderate
Artery abnormal
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Intima dissection
Partial/complete transsection
Partial/complete ligation
Unidentified arteries
Origin/renal artery stenosis
Venous anatomy/status
Venous anatomy/status
Agree
Disagree
Number of veins 2
Caval patch Yes
Vein abnormal
Venous tear
Partial/complete transsection
Partial/complete ligation
Unidentified veins
Ureter anatomy/status
Ureter anatomy/status
Agree
Disagree
Number of ureter
Length of ureter (long is > 10 cm) Long
Parenchymal anatomy/status
Parenchymal anatomy/status
Agree
Disagree
Aspect perfusion Good
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10. Score Systeem QFT’s
Score
Uitleg
A
Geen opvallendheden
B
Definitie verschil of afwijkende anatomie
zonder problemen
C1
Schade die voorkomen had kunnen
worden, orgaan wel tx
C2
Schade die voorkomen had kunnen
worden, orgaan niet tx
D1
Niet te voorkomen schade wel tx
D2
Niet te voorkomen schade, niet tx
E
Praktische problemen
11. Aantal procedure en afwijkingen per
Centrum
TX
centrum Aantal nieren
A
B
C1
C2
D1
D2
E
I
110
83
20
14
2
2
1
1
II
77
55
17
16
0
2
0
3
III
50
16
15
27
0
3
1
2
IV
100
65
19
24
0
2
2
2
V
78
51
21
13
3
2
1
6
VI
5
2
1
3
0
0
0
0
TOTAAL
420
280
92
96
6
16
4
14
12. Mogelijk te voorkomen schade
Aantal nieren
%C1+C2
I
110
15 %
II
77
21 %
III
50
54 %
IV
100
24 %
V
78
21 %
VI
5
60 %
